A White Coat Syndrome Story

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It is a Tuesday morning. You are sitting in the waiting room of your doctor’s office. You have an appointment to discuss the lab test results from your recent annual check-up. Your blood pressure at that time was 140/90. The nurse will be measure it again just before you see the doctor this morning. How are you feeling as you wait? What do you think your blood pressure will be today?

Your name is called. You are ushered into an exam room and seated on the edge of the exam table. Nurse Megan comes in, gets your weight and measures you pulse/oxygen level. Your weight is unchanged and your pulse/ox is better than 98%. She puts a blood pressure cuff on your preferred arm and records a level of 150/95. She tells you the doctor will be with you soon, walks out and closes the exam room door. How are you feeling now? Are you calm and relaxed or maybe a bit anxious and stressed?

The good doctor comes in, greets you warmly, settles in his chair and pulls up your chart on his laptop. He tells you he has some good news and some concerns. Which do you want first? You opt for the good news. The good news is that all of your lab results are in normal range and your general health is very good. However, he is concerned that your blood pressure is high and the possibility that you may be developing something called persistent hypertension. He suggests that you start monitoring your blood pressure at home and schedule a follow-up appointment in about 3 months.

As you drive home from your appointment your head is full of questions. What exactly is persistent hypertension? How serious is it? Are there treatment options? Is there such a thing as non-persistent hypertension?

Google to the rescue! First you learn that persistent hypertension may be defined as when your average arterial blood pressure during a normal day, the force of your blood pushing against the walls of your blood vessels, is consistently 130/80 or higher.

But then you also discover that there is a thing called White Coat Hypertension or White Coat Syndrome which is defined as a medical condition in which you experience persistent high blood pressure when you are measured at your doctor’s office or when a physician is present, but you experience normal blood pressure levels during your daily life and while in your home environment.

Next you learn that
• Hypertension progressively damages the walls of large arteries and makes the heart work harder to get blood pumped through the body.
• Modern medical treatments for persistent hypertension include diuretics and an array of drugs that aim to lower your blood pressure. Doctors also recommend lifestyle changes including diet and exercise
• White Coat Hypertension is associated with anxiety and fear of doctors and medical settings based on your past experiences and beliefs. If you are afraid to go to the doctor or dentist it can cause your blood pressure to rise when you are seeing the doctor and you may be treated unnecessarily for high blood pressure that you don’t really have.
• White Coat White syndrome can progress to persistent hypertension which causes problems that might have been avoided had you dealt with them earlier.
• Research studies have also established that Hypnosis/Hypnotherapy is effective in reducing blood pressure both in the short term and long term.

How can you fix this? Hypnotherapy can help in several ways. First, we attempt to find where the fear/belief comes from and if it is something that by reason alone can be fixed. Then we craft affirmations that encourage you to be calm and relaxed when having a medical procedure. Another technique would be for you to imagine yourself having the procedure in your imagination. Your very clever mind cannot tell the difference whether or not you are mentally rehearsing having your blood pressure taken or are actually having it taken by a doctor or nurse in a white coat.

If you would like to talk with me about your high blood pressure or have questions, please give me a call.